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REDUCING colorectal CANCER disparities IN SAN FRANCISCO

SF CAN aims to combat colorectal cancer disparities through targeted early detection and follow-up of aggressive disease, and institutional partnerships that ensure high-quality treatment citywide. 

  • American Cancer Society

  • Colon Cancer Coalition

  • Fight CRC

  • Kaiser Permanente

  • Operation Access

  • San Francisco Bay Collaborative Research Network

  • San Francisco Community Clinic Consortium

  • San Francisco Community Clinic Consortium partner clinics

    • HealthRIGHT 360

    • Mission Neighborhood Health Center

    • South of Market Health Center

    • St. Anthony's

  • San Francisco Health Network

  • San Francisco Health Plan

  • UCSF Health

  • Zuckerberg San Francisco General Hospital

 

partner organizations

September 2020:  Alarming Trends in Colorectal Cancer

The recent death of actor Chadwick Boseman from colon cancer at age 43 is drawing attention to the alarming increase in cases among adults under the recommended screening age, as well as racial disparities for case rate and mortality.
 

Boseman was diagnosed when he was only 39 year old in 2016. This young age is far below the current recommendations from organizations to begin screening that hover at ages 45 or 50. Moreover, his death highlights the fact that Blacks incur the highest incidence and mortality rates of colorectal cancer of any ethnic group in the United States, being more often diagnosed with CRC at an earlier age and with more advanced disease.
 

  • Oncologists: Chadwick Boseman’s death from colon cancer at 43 underscores a disturbing trend 
    By Sorbarikor Piawah, Gabriel A. Brooks and Franklin W. Huang | SF Chronicle | Sep. 3, 2020

     

    ...There exist persistent racial disparities — Black colon cancer patients are 40% more likely than white patients to die from their cancers. While Mr. Boseman’s cancer would not have been detected under current screening guidelines, it is clear that detecting colon cancer earlier and identifying individuals at higher risk should be an important priority... > read more
     

  • UCSF doctor hopes death of actor Chadwick Boseman will raise awareness as more young people diagnosed with colon cancer 
    Featuring Dr. Alan Venook | ABC7News.com | August 30, 2020

     

    ..."Younger people with symptoms, let's say bowl symptoms, diarrhea, or blood in their stool, will know that they may be at greater risk of colon cancer than they thought and will be seen by their physicians. Perhaps more important, the physicians, primary care doctors, need to be thinking of colon cancer earlier than they usually would. You tend to dismiss a 30 or 35 year old as not likely to have cancer. Well, we unfortunately see that that's changed."  >read more

colorectal cancer: in the news

 
 

get involved

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strategY: Improved screening and follow-up to colonoscopy at SF safety net clinics

The SFCAN Colorectal Cancer Task Force aims to reduce colorectal cancer morbidity and mortality in San Francisco. The greatest opportunity to achieve this goal is to increase screening and detection, particularly within uninsured and underinsured populations who receive care in resource‐limited clinical settings.

 

To achieve this goal, our task force has chosen to focus primarily on clinical interventions in partnership with healthcare organizations serving San Francisco’s safety net populations.

Additional activities to support this goal have included events and partnerships to raise community awareness, agreements with vendors to develop innovative patient services, and engagement with other health systems that provide care to health disparities populations in an effort to improve screening rates and screening quality for all their patients.

Leads:
Michael Potter, MD, Dept. of Family and Community Medicine, UCSF
Ma Somsouk, MD, MAS, Dept. of Medicine, UCSF

PEER RECOMMENDATIONS ON METHODS TO INCREASE SCREENING

 

current projects:

Healthcare partnerships:

A webinar that is being promoted by the National colorectal Cancer Roundtable about re-igniting CRC screening activities as communities face and respond to the Covid 19 pandemic.  Ma Somsouk will be one of the speakers.  It will take place Thursday July 23, 2020

Read: 
REIGNITING COLORECTAL CANCER SCREENING AS COMMUNITIES FACE AND RESPOND TO THE COVID-19 PANDEMIC (NCCRT Playbook)

Partnerships with the following:

news and updates

Overall Progress Made and Major Achievements (07/01/19-06/30/20)

Health Care System Partnerships:

SF-CAN has had success in supporting safety net clinics belonging to the San Francisco Community Clinic Consortium in a variety of ways, including providing technical assistance to increase screening rates, thorough reporting systems, and improving patient navigation to ensure that people with abnormal screening tests received timely follow up.

UCSF, the American Cancer Society, San Francisco Health Plan, Zuckerberg San Francisco General Hospital, and other community stakeholders have partnered in these efforts.

Community Engagement:

According to our current logic model, many of our Intermediate Outcomes (2‐5 years) have been achieved. This includes ongoing community engagement, increased screening rates in safety net settings, and with all clinics using single sample FIT, and systems level interventions to support evidence‐based screening procedures.

 

There is still more work to do to support higher rates of colonoscopy follow up for high risk patients such as those who have had an abnormal FIT, which is currently challenging due to rescheduling of elective procedures in the setting of the Covid‐19 epidemic.

Publications 

The following papers are a mix of nationally and locally relevant resources for people who are interested in the learning more about screening, screening recommendations, and some home grown interventions in diverse settings that have made a difference.

 

 

Importance of Colorectal Cancer Screening

 

Statistics

Colorectal Cancer Disparities

  • Potter MB. Strategies and resources to address colorectal cancer screening rates and disparities in the United States and globally. Annu Rev Public Health. 2013; 34:413-29. PMID: 23297661.

Increasing Colorectal Cancer Screening in Diverse Settings

  • Hiatt RA, Sibley A, Fejerman L, Glantz S, Nguyen T, Pasick R, Palmer N, Perkins A, Potter MB, Somsouk M, Vargas RA, van 't Veer LJ, Ashworth A. The San Francisco Cancer Initiative: A Community Effort To Reduce The Population Burden Of Cancer. Health Aff (Millwood). 2018 01; 37(1):54-61. PMID: 29309234.
     

  • Potter MB, Ackerson LM, Gomez V, Walsh JM, Green LW, Levin TR, Somkin CP. Effectiveness and reach of the FLU-FIT program in an integrated health care system: a multisite randomized trial. Am J Public Health. 2013 Jun; 103(6):1128-33. PMID: 23597357.
     

  • Sarfaty M, Doroshenk M, Hotz J, Brooks D, Hayashi S, Davis TC, Joseph D, Stevens D, Weaver DL, Potter MB, Wender R. Strategies for expanding colorectal cancer screening at community health centers. CA Cancer J Clin. 2013 Jul-Aug; 63(4):221-31. PMID: 23818334.
     

  • Walsh JM, Gildengorin G, Green LW, Jenkins J, Potter MB. The FLU-FOBT Program in community clinics: durable benefits of a randomized controlled trial. Health Educ Res. 2012 Oct; 27(5):886-94. PMID: 22641790.

Improving Colorectal Cancer Screening and Follow-Up Logistics

  • Issaka RB, Rachocki C, Huynh M, Chen E, Somsouk M. Standardized workflows improve colonoscopy follow‐up after abnormal fecal immunochemical tests in a safety‐net system. Digestive Diseases and Sciences. March 2020. https://doi.org/10.1007/s10620‐020‐06228‐z

  • Somsouk M, Rachocki C, Mannalithara A, Garcia D, Laleau V, Grimes B, Issaka RB, Chen E, Vittinghoff E, Shapiro JA, Ladabaum U. Effectiveness and cost of organized outreach for colorectal cancer screening: A Randomized Controlled Trial. J Natl Cancer Inst. 2019 Jun 12. PMID: 31187126

 

  • Wang A, Rachocki C, Shapiro JA, Issaka RB, Somsouk M. Low Literacy Level Instructions and Reminder Calls Improve Patient Handling of Fecal Immunochemical Test Samples. Clin Gastroenterol Hepatol. 2019;17(9):1822‐1828. PMID: 30503967

 

colorectal cancer: in the news

San Francisco Cancer Initiative 2020

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